Military GP highlights disease threat

Disease, and not just combat injury, poses a key threat
to soldiers on the modern battlefield, as it did in World War
1.

Major Sean Clarke (43), a University of Otago graduate who is
a military GP serving with the British Army in the Royal Army
Medical Corps, and based in northern Germany, was speaking in
Dunedin yesterday.

He gave a special lecture entitled ''Military General
Practice on Deployment in Afghanistan'', at the Otago general
practice and rural health department.

Much media attention was understandably given to battlefield
combat injuries, such as those caused by gunfire or
explosions, he said in an interview.

But a bigger overall challenge to combat fitness among troops
was ''disease and non-battle injury'' (DNBI) casualties,
arising from various infections, including skin complaints,
he said.

Although diseases contracted during combat were rarely fatal
these days, since the advent of antibiotics, they affected
many more people than combat injuries. Such illness could
make it more difficult for military units to operate, and
''can cause a lot of stress'', Maj Clarke said.

He recently completed a nine-month deployment in Helmand
province, in south central Afghanistan, working at a forward
base providing primary health care to soldiers.

Sometimes, more junior commanders could have to assume
greater responsibilities if senior staff were ill. Although
soldiers serving in Afghanistan did not have to face the
horrors of World War 1-style trench warfare, they also faced
an ''austere environment''.

In Afghanistan, they had to cope with clouds of dust and sand
and temperatures of 40degC or greater by day and, at times,
plunging to sub-zero temperatures overnight.

And when it rained heavily, dust could rapidly turn into
''horribly muddy, boggy conditions''.

Although bullets and bombs remained a big challenge on the
modern battlefield, maintaining good hygiene, including
regular hand washing, was as important as it was in World War
1.

''It's an issue of personal hygiene,'' he said.

Maj Clarke is the Regimental Medical Officer for the 4th
Battalion (The Highlanders), The Royal Regiment of Scotland,
and is based in northern Germany.

He completed his BSc (Hons) and PhD, the latter in botany, at
Otago University in the mid-1990s, before starting
post-doctoral research in the UK.

He completed his medical degree at the Queen's University of
Belfast in 2006.